Various surgical instruments are known that require manipulation in the anal canal, e.g. anoscopes sigmoidoscopes, forceps, hemorrhoid ligators, etc.
Unfortunately, the prior art instruments are not convenient in use, since at least three hands are required to manipulate them and therefore they necessitate the presence of an assistant, which should operate in a coordinated manner with the surgeon. It can be readily appreciated that this complicates the medical procedure and renders it less efficient. Furthermore, since the instrument is not supported, the position thereof is not spatially determined and therefore it should be manipulated with very extra care, which renders the procedure inconvenient and tiresome.
There are known attempts to overcome the above problems.
For example, U.S. Pat. No. 5,158,563 discloses a single-operator hemorrhoid ligator, comprising a forceps, an endoscope with a fixedly attached track, an obturator, receivable within the endoscope and a loading mandrel, allowing an elastic ring to be mounted on the ligator. By virtue of combination of three instruments (ligator, forceps and endoscope) in one and by virtue of the fact that forceps and ligator are self-retained within the endoscope and supported by the track, the ligation procedure can be performed by a single operator, thus eliminating the necessity for assistance.
Unfortunately, this device is devised solely for ligation purposes and it is not intended for the other surgical procedures, which might be required during rectal treatment and which employ other surgical instruments.
Furthermore, the construction of the loading mandrel of this ligator enables loading of only single rubber ring and therefore it is required to reload the instrument after each ligation.
It can be readily appreciated, that the necessity in reloading of the ligator renders the whole ligation procedure time consuming.
In U.S. Pat. No. 5,464,412 is described a surgical instrument for elastic ring ligation of hemorrhoids by a solo operator. The instrument is formed as double-barreled endoscope, consisting of an exterior barrel and an interior barrel receivable within the external barrel. The operator inserts the tool into a body orifice by his one hand. The distal end of the interior barrel is loaded with a ring by means of a loading mandrel and the instrument is placed in the orifice aided by an obturator. The obturator is removed and the instrument is positioned to bring the target area into view. The selected tissue is drawn into the interior barrel, which functions as ligator. The operator can now pull the trigger on proximal end of the interior barrel, which retracts the barrel and releases elastic ring to be released by the exterior barrel.
This tool is also limited strictly to ligation of hemorrhoids and is not capable of carrying any other instruments required for other types of treatment.
There are known also in the art endoscopic tools in which by exchange of the surgical instrument it is possible to perform different treatments without necessity to introduce additional tool in the operation field.
An example of such multifunctional endoscopic surgical tool is disclosed in U.S. Pat. No. 5,186,714. This tool has been devised for laparoscopic surgery and it is suitable for several applications, e.g. percutaneous surgery, cholecystectomy, gynecology, neurosurgery and urology.
The tool is configured as a pistol-grip holder on which a tube or trocar with an interchangeable surgical instrument is mounted. The tool also comprises a cartridge, which is removably mounted on the holder and incorporates valves and tubes for connection to a source of vacuum and a source of flushing fluid. By virtue of this construction the tool can be used for many operations, like irrigation or suction of physiological matter, suction of gas or vapors, electrocautery, laparoscopy or laser surgery.
Unfortunately this multifunctional tool is limited strictly to laparoscopic surgery and it is not suitable for mounting of instruments, which usually are required for carrying out proctologic endoscopic operations within the anal canal.
It should be emphasized that despite the fact that different surgical devices for proctologic and other applications have been devised there still exists a need for a new and improved device which will ensure easy and convenient manipulation by different instruments during surgical treatment within the anal canal.